Do you have any successful Quality Improvement initiatives in relation to LTCs in a healthcare setting that others might adopt? If so, we want to hear from you in order to share your learnings with others and allow them to achieve the benefits that you have achieved.

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Please answer each question in brief manner (e.g. around 200 words per question) capturing the key information utilising the following word document that can then be uploaded to Meridian once completed.

Name:Contact Details:(Please note that others reading this completed report will be able to contact you with details you give here)E-mail:Telephone:Team relevant to the successful QI project reported here:Date submitted:

1. The problem or issue you addressed that is relevant to the delivery of long term condition(s) care or redressing of adverse lifestyle habit(s)Which problem or issue did you address?How did you know it was a problem?Who was it affecting?Had it been tackled before?

2. Baseline measurement Before you started how did you measure or assess the scale and scope of the problem?Have you baseline data?

3. What intervention(s) you did What did you do; what was the healthcare setting?How did you engage with key stakeholders, including patients, in identifying the problem or issues and designing the solution?Who were the subjects of the intervention, and who helped deliver it?When did the intervention start (dates)?What evaluation did you undertake; what did you measure and how did you measure it?

4. Your findings What were your end-of-project results (exactly what did you measure and how did you measure it - have you any tables or figures you can share)?

6. Looking backwards and forwards What feedback– positive and negative - did you get eg from patients/carers, populations, staff, commissioners?What challenges did you face? Did you overcome them? How?If you repeated the project what would you do differently?Has your intervention now become routine practice? Yes / No

If Yes, will it be sustainable in the long term?

If No, why not?

7. Learning from othersHas the problem you addressed (similar or related) been tackled by others? What did they do? Were they successful?

Pulmonary rehabilitation in the form of exercise has been shown to elucidate positive effects on COPD patients (Puhan et al., 2012). Move it or Lose it! are specialists in exercise for the over 60s and have been commissioned by Birmingham CrossCity CCG to deliver exercise classes called FABS (Flexibility, Aerobic, Balance & Strength) to COPD patients in an initiative to promote health and well-being. Following a successful pilot study, the programme has been rolled out across the CCG.

The aims of the programme are to; 1.) improve patient health and quality of life, 2.) educate and empower patients to take control and self-manage their condition, thus reducing time for GP appointments, hospital admissions and their associated costs. and 3.) monitor and evaluate the physical and psychosocial function of the patients.

So far, forty-three COPD patients (mean age range 60-70 years) have completed a once weekly 45-minute exercise class, followed by educational group discussions based at their GP surgery. Timed Up and Go (TUG), 30 second sit to stand and self-report questionnaires were used to monitor and evaluate physical and psychosocial elements of health and wellbeing.

Results indicated mean group improvement of 44% in TUG and 150% improvement in 30 second sit to stand scores, demonstrating improved lower limb strength, functional mobility and independence. Questionnaires highlighted elevated mood and energy levels and high levels of enjoyment and social interaction. Correlation coefficient (r) scores showed strong to very strong positive correlations in results from different instructors. Patients have also reported a reduced need for medication during the 12-week programme and this was sustained after a six week follow up.